- Lymphoedema is a long term condition that affects over 240,000 in the UK.
- One in nine women will develop breast cancer and Lymphoedema can affect up to 28% of these patients.
- This is a disabling and psychologically distressing condition, often removing people from society and the workplace.
- Patients with Lymphoedema and chronic oedema will have a high risk of developing cellulitis and sepsis
- Inappropriate or delayed referral and treatment will lead to complications and avoidable hospital admissions.
- For every £1 spent on Lymphoedema the NHS saves £100 in reduced Hospital admissions (CSP Publication 2015)
We are an Award winning local Social Enterprise providing NHS Lymphoedema, Lipoedema and Chronic Oedema Lymphoedema Services in the West Midlands and beyond. We are able to accept referrals from anywhere in the UK. Our specialist team offer the following solutions in the management of Lymphoedema, Lipoedema and Chronic Oedema:
- Comprehensive assessment and diagnosis.
- An Individual and holistic plan of care to help empower patients to manage and improve their condition
- Cost Effective Arterial Assessment – (using Vascular Assist-Toe Brachial Pressures – TBPI)
- Intensive treatment packages
- Specialist Compression Bandaging
- Medical Lymphatic Drainage (MLD)
- Low Level Light Therapy
- Exercise Programmes- Including LymphYoga
- Pneumatic Compression pump systems and home loan
- Measurement and fitting for Specialist Compression garments and Bras
- Facilitate Patient Forums and Support Groups
- Home visits for housebound patients
- Weight management initiatives for patients in this patient group with a high BMI
- Joint consultations and integrated and shared care of Complex Patients with chronic oedema/Lymphoedema and leg ulceration, including bariatric Patients.
- Preventing and reducing Hospital Admissions with appropriate specialist care at the right time and place.
LymphCare UK is a trusted provider of high-quality specialist advice and care for people at risk of or living with lymphoedema, lipoedema, chronic oedema and associated conditions.
Our purpose is to improve people’s lives. We do this through cost-effective and innovative prevention, advice, treatment, guidance and supervised self-care.
We continue to lead on increasing public awareness and to widen access to services, through innovation, research, education and training.
Our Vision is to strive for equitable access and to drive up national standards.
We are a social enterprise. We manage our business with the social purpose of caring for people living with lymphoedema, lipoedema and chronic oedema and associated conditions.
We are motivated to make a profit, and to invest that profit back into our purpose, thereby aligning our social purpose and our profit objective.
Our staff are our shareholders; they are passionate and dedicated to our purpose and support LymphCare UK and its values.
Social Impact Reporting
Saved Dudley CCG £122,844 by working innovatively with supervised home based self-care treatments.
LymphCare UK provided 2537 clinical interventions from January 2016-17.
We provide opportunities to individuals with learning difficulties and those who find the work environment hard to access.
A quality of Life tool. The LYMQOL results showed a maintenance or improvement in the overall Quality of Life (QOL) Scores, with 62.5% maintaining their score and an improved QOL in 37.5%. Function improved in 87% of the group and emotional domain scores improved in 75% of the group.
LymphYoga – a specially designed programme for our patients who would not normally access this activity. 62.5 % of patients saw a reduction in the volume of their affected Lymphoedema Limb and 50% achieved weight loss. 87% had an improvement in Emotional Dom.
Our clinical interventions are transforming patients lives by: reducing the need for district nurse visits – reduced episodes of cellulitis and hospital admissions – Lymphcare UK enable patients to become active again in society.
Our patients stories prove this.
Compassion – we continue to develop a culture dedicated to having time to listen to and care about our patients, staff and the community which we serve.
Awareness – we are committed to raising the profile of lymphoedema, lipoedema and chronic oedema and to be a national voice for those affected by the condition.
Responsiveness – we think creatively and adapt to the changing economic and social climate and to re-invest time and resources in improving people’s lives.
Excellence – we are a passionate, innovative and an expert in the speciality and strive to continue our growth and develop a committed and competent team and organisation.
National Health Imperatives
Lymphoedema is fundamentally an under-resourced service and under-recognised condition.
The Lymphoedema Support Network (LSN) states that ‘’Lymphoedema is a long term condition which current research and expert opinion supports, affects between 1.33 and 3.99 per 1,000 population.
Prevalence increases significantly with age and based on these figures it is estimated that between 76,000 and 227,000 men, women and children in England are living with the condition.
This would equate to an average of 400 to 1,000 per Clinical Commissioning Group.” A minimum of 11% of patients in the UK has lipoedema, again this condition is significantly under-diagnosed.
Three identified risks for Lymphoedema are older age, having a cancer diagnosis and obesity — current projections suggest that all of these categories are expected to increase dramatically and as such the prevalence of Lymphoedema will inevitably increase (Lymphoedema Support Network, July 2014).
It is estimated that for every £1 spent on lymphoedema treatments to limit swelling and prevent further damage and infection, the NHS saves £100 in reduced hospital admissions. Untreated lymphoedema costs the NHS more money in the longer term.
- NICE (2004) Improving Supportive and Palliative Care for Adults with Cancer
- NICE Clinical Guideline: Breast Cancer (advanced) 2009
- NICE Improving Outcomes Guidance: Breast Cancer (early and locally advanced) 2009
- National Cancer Action Team (2010) Rehabilitation Workforce Model
- National Cancer Action Team (2009) Rehabilitation Care Pathway: Lymphoedema
- NHS Wales (2008) , Strategy for Lymphoedema in Wales
- Lymphoedema Framework. Template for Management: developing a Lymphoedema service. London: MEP Ltd, (2007).
- Lymphoedema Framework. Best Practice for the Management of Lymphoedema. International Consensus. London. MEP Ltd (2006)
- International Lymphedema Framework – ‘The Management of Lymphedema in Advanced Cancer and Oedema at the End of Life (2010)
- NHS Outcomes Framework 2016/2017 – (Domain 2 – 5)
- Five Year Forward View (2014) – ‘care closer to home’
- Department of Health (March 2005) The National Service Framework for Long Term Conditions
- NICE Guidance (2008) Liposuction for chronic lymphedema
- Lymphoedema Services (2005)
- Guidelines for the diagnosis, assessment and management of Lymphoedema (CREST 2008)
- Supportive and Palliative Care in Adults, The Manual. (NICE 2004)
- The Management of Lymphoedema in Advanced Cancer and Oedema at the End of Life: Position Document International Lymphoedema Framework (2010)
- Best Practice for the Management of Lymphoedema -2nd ed. Compression Therapy: A position document on compression bandaging (2010)
- Practice for the Management of Lymphoedema -2nd ed. Surgical Intervention: A position document on surgical intervention (2012)
- Lymphoedema The Way Forward: A focus document (2010)
- NHS Wales (2009) Lymphoedema – Strategy for Wales Moffatt et al. (2003) Lymphoedema ; An Underestimated Health problem. QJM (2003) 96 (10): 731-738
- Lymphoedema Services in England – A Case for Change (2003) National Cancer Action Team.
- Best Practice Statement – Holistic Management of Venous Leg Ulceration
Our Concepts of Care for Complex Long-term Conditions
(Context: Chronic diseases are now the most common cause of death and disability in England. More than 15 million people have a long-term condition and tend to be heavy users of health care resources. The prevalence of long-term conditions rises with age, affecting about 50 per cent of people aged 50, and 80 per cent of those aged 65. Many older people have more than one chronic condition, but in absolute terms, there are more people with long-term conditions under the age of 65 than in older age groups).
The management of care for people with long-term conditions should be proactive, holistic, preventive and patient-centred.
At LymphCare UK we work on the principle of a personalised coordinated service delivery model.
Our ‘Complete Care’ model differs from other providers in two important ways: it encompasses all people with long-term conditions, not just those with a single disease or in a high-risk group; and it assumes an active role for patients, with collaborative personalised care planning at its heart. Implementing Our Complete Care Model requires everyone at LymphCare UK to move away from traditional ways of thinking and behaving and shift to a partnership model in which patients play an active part in determining their own care and support needs and care professionals work with each other to coordinate the plan.
People with long-term conditions are managing their health on a daily basis, but they may need additional help to develop their confidence in fulfilling their role as a self-manager. With this in mind our Complete Care Model has seven key elements:
- Prevention and early diagnosis
- Comprehensive initial assessments
- Patients engaged and empowered in decisions about their care
- Personalised coordinated care planning
- Supported self-management
- Emotional, psychological and practical support
- Re-ablement, rehabilitation and domiciliary care
Prevention and early diagnosis
In terms prevention, we use our wealth of expertise and understanding of long-term conditions for informing and supporting people to improve their general health and well-being by adopting healthy behaviours around physical exercise, diet and smoking.
We know that early diagnosis for many conditions, which can reduce the severity of illness, minimise the chances of suffering adverse complications, reduce the need for late stage complex interventions and improve outcomes.
Comprehensive initial assessments
At LymphCare UK our initial assessments are comprehensive and are focussed on our holistic approach and undertaken by senior practitioners.
We take into account physical and mental health and history, social, ethnic and cultural background and circumstances. It a recognises that there are other issues in addition to medical needs that can impact on a person’s total health and well-being.
We explore strengths as well as the areas of concern, so as to look behind the presenting issues and come up with a more holistic view.
We also take care to explore personal goals, outcomes and motivation to ensure that patients are totally engaged and own the subsequent plan.
Patients engaged in decisions about their care
Communicating information effectively, treating people with dignity and respect as individuals is central to engaging patients in decisions about their care.
We are focused on helping patients to weigh up the benefits and risks of treatment options and encouraging patient-led decisions through appropriate coaching support.
We ensure that all Health care professionals at LymphCare UK have the skills and techniques needed to help patients manage their own health and make informed decisions, ensuring the quality and effectiveness of patient interactions.
Patients are involved in identifying areas for improvement and designing or shaping services that meet their needs through our Patient Engagement Group.
Personalised coordinated care planning
In personalised care planning, our clinicians and patients work together using a collaborative process of shared decision-making to agree goals, identify support needs, develop and implement action plans, and monitor progress.
This may include support to enhance their ability to manage their tests or medicines, to make changes to their lifestyle or to cope with the emotional and social consequences of living with a long-term condition. Where care planning takes place, how frequently, with whom, and how each step is designed will vary according to the individuals’ needs.
The important point is that care planning, implementation and review is a continuous process over a period of months or years, not a single one-off event.
In addition to clinical interventions, our care plans cover general and condition-specific self-management and peer-led support, as well as providing signposting to assistance with wider emotional, psychological and practical needs with approaches such as structured social prescribing.
Self-management involves assisting individuals to make choices and decisions about managing their condition in order to improve their overall health, well-being and quality of life.
At LymphCare UK people with long-term conditions will be offered and have access to a range of flexible, responsive self-management support including tailored information and advice and structured programmes to help them manage their condition successfully.
The type and level of support people require will vary, but the main elements of successfully supported self-management involve a mix of personalised information, such as living well plans, structured education and training, and the ability to access specialist advice from other trained professionals and volunteers or through online or face-to-face peer support when needed.
We have collaborative care arrangements agreed between other primary care, mental health services and other third sector organisation, which increases our patient’s ability to adopt healthy behaviours and to feel more able to self-manage their condition.
Emotional, psychological and practical support
Long-term conditions place people under significant and sometimes severe emotional and psychological strain. They can also lead to a huge range of practical difficulties in daily living, particularly during the recovery period after a hospitalisation when the need for rehabilitation and re-ablement is greatest.
Emotional, psychological and practical needs are routinely assessed during the care planning process to support facilitated access to appropriate services where this is needed for example; complimentary therapies, anxiety management, peer support, and befriending schemes.
Re-ablement, rehabilitation and domiciliary care
Re-ablement at LymphCare UK is all about ‘helping people to do for themselves rather than doing it to or for them’.
It is short term, intensive support that enables people to optimise their independence. The aim of rehabilitation is to maintain or increase independence, allowing patients live in their own home for as long as possible. When necessary, we ensure that all of our patients are referred to any of the required short-term care support and/or therapeutic interventions they need, for example, physiotherapy or occupational therapy.
Depending on the condition we can provide carefully chosen home care (domiciliary care), with a qualified practitioner. This is an excellent way for us to ensure patients retain their freedom and independence, whilst getting the help they need to stay well and safe.